Understanding Internet Gaming Disorder

Updated: Jul 25


IGD is based less on the number of hours dedicated to gaming, but rather the extent of compulsion to play…”

Author: Rhea Verma

There are about 2.5 billion active gamers across the globe, of which Canada alone is host to over 23 million gamers, 692 gaming companies, and a $3.6 billion industrial revenue [1-3]. Among the many types of addictions we have come to understand, videogame addiction, today commonly known as Internet Gaming Disorder (IGD), tends to be overlooked, yet has consequences which are no less detrimental [1,4].

The criteria for diagnosing someone with IGD is based less on the number of hours dedicated to gaming, but rather the extent of compulsion to play and how this affects other aspects of the person’s life [5].

There have been hundreds of international studies on the impact of videogames on human psychology and wellbeing. In this article, let’s break down some statistics and findings from such studies, and educate ourselves on what IGD really is.

Understanding the Extent of the Issue

The term ‘gaming disorder’ was first presented in the World Health Organization’s (WHO) International Classification of Disease Edition 11 (IPC-11) in May 2018 [6-8]. The IPC-11 is the international standard for identifying and reporting diseases and health conditions [6].

This addition was controversial, and incited great debate from the international fronts of the esports and gaming industries [8]. Yet, the reality of the situation was far from unknown, especially in the Asian market [5,8, 9]. For example, South Korea declared IGD as a national health emergency in 2011, introducing their Cinderella Law: all videogames would automatically shut down for all children under the age of 15 after midnight [9]. This law was specifically put in place after over 600 thousand children were diagnosed with IGD [1].

Over 90% of South Korean adolescents preferred videogames as their regular pastime, and there have been several public reports of malnourishment, infection, and violence among this population [9, 10]. Some news outlets even dubbed videogame entertainment as ‘electronic heroin’, and the issue has demanded urgent mental health resources and counsellors to assist in ‘digital detoxification’ programs [11].

With China being one of the largest gaming markets, it was a shock to the industry when the country placed six major restrictions on the act of gaming in November 2019 [5, 12]:

  1. Gamers must register for online game accounts with your real name

  2. Gamers can game for a maximum of 90 minutes per weekday and up to 3 hours on weekends

  3. Gamers cannot play online games between 10pm – 9am

  4. Gamers will have monthly spending limits on games depending on your age

  5. The gaming industry will always monitor gaming behaviour and enforce compliance

  6. The gaming industry and gamer’s parents will have full access to monitor played games for content

The Chinese Government justified these restrictions by blaming videogames for increased near-sightedness and decreased academic performance displayed especially among minors [12]. It is debatable whether or not other factors played a role in those two statistics, however.

In argument, it is commonplace for many Asian countries to have large gaming/Internet cafe franchises set up which are very popular hotspots for youth to gather at [13]. Wanyoo, Asia’s largest gaming cafe franchise serving over 30 million gamers annually, recently opened their first branch in London, UK, in October 2019 [14]. Is this common cafe culture what drives addiction rates? More research is required before an answer can be determined.

While COVID-19 has greatly disrupted the esports sector, the gaming trend only continues to skyrocket now that gamers new and old alike have more time than ever before to indulge in the glories of new virtual worlds [15]. The global videogame market is projected to hit the $159.3 billion mark by the end of 2020 — a 9.3% increase from 2019 figures! — where mobile games make up about 48% of that revenue [15].

Surprisingly, WHO substance use and addictive behaviour expert Dr. Poznyak states that an individual’s risk of developing IGD is not significantly impacted by their geographical region [1]. This suggests that the issue may exist to the same extent even in North America, but the issue is less emphasized overall [1].

Original Artwork by Sara Mizannojehdehi

Understanding the Progression

According to Dr. Lal from Healthy Gamer, videogame addiction onsets in a three-step model [4]:

  1. Gamers play videogames for several hours have fun with it

  2. Gamers play videogames for several hours but instead of having the original amount of fun, they play to elevate their mood

  3. Gamers play videogames for several hours out of compulsion instead of primarily for fun and/or a better mood

When an individual starts to play videogames for the first time, the experience is fun, new, experiential, and causes the brain to release dopamine, which causes our bodies to feel pleasure [4]. Over an extended period of time, our bodies adapt to this dopamine release and stop feeling the same level of pleasure from the act of gaming; this is referred to as building a tolerance [4].

This is similar to building a caffeine tolerance; you can start drinking a cup every morning right before exam week to give you a boost of energy, but eventually the taste grows on you, the habit sticks and you start drinking it regularly even if it is not for the energy boost, and on the day you don’t get your morning cup of coffee, you lead your day feeling incomplete [4]. Another relevant example: when you watch a professional Twitch streamer say that ‘there are no fun games out’ when in reality, they have dedicated hundreds of hours to mastering a game, but simply lost the ability to feel the dopamine’s effect [4].

Of course, this is not an irreversible issue, and ‘digital detoxification’ has been successful to an extent, although it can be quite difficult based on the gamer’s level of progression into their addiction — a common problem among all types of addiction [4].

Past studies have emphasized a need for greater family involvement and support in their childrens’ lives to help them find alternative pastimes and interests [16]. When children use videogames to escape from the real world, they are more likely to be at risk for IGD than if they had the appropriate family support and encouragement to try other things from an earlier age [16].

While playing videogames may not directly be a fatal act, it is possible to die as a consequence of videogame addiction [9]. Imagine being a gamer who develops the mindset that stepping away from the screen even for a moment means you won’t achieve a high score. Imagine being a professional gamer who has a tournament coming up, who needs all the practice they can get. How would this affect your social relationships? How would this affect your mental and physical health, to be glued to a screen for hours on end? Addiction of this sort can easily lead to problems with vision, sleep deprivation, ADHD, stress, obesity, and several other consequences [10, 17].

Understanding Moderation

Roh Sung-won, an addiction specialist and psychiatry professor at the Hanyang University Hospital in Seoul, makes a very noteworthy analogy: “Alcoholics don’t blame the company that makes the liquor. You don’t stop manufacturing cars because there are automobile accidents” [9]. The same way, a lesson to take away is that the existence of IGD and its relevant consequences does not mean that videogames or their creators are an evil in this world.

Further research into the subject would be beneficial to refining the true scope of the issue, but most importantly for gamers themselves: moderation is key — even water can kill you if you drink too much too quickly [18].

Alcoholics don’t blame the company that makes the liquor….The same way…the existence of IGD and its relevant consequences does not mean that videogames or their creators are an evil in this world”

Editors

Rushil Dua & Mouayad Masalkhi

Designer

Sara Mizannojehdehi & Richard Chen

Additional Credits

Header Image by Fredrick Tendong @frdx from Unsplash

References

  1. Kanojia A [Internet]. Healthy Gamer; 2020. Video game addiction statistics 2020: is the world addicted to video games?; 2019 Nov 7 [cited 2020 Aug 16]. Available: https://www.healthygamer.gg/video-game-addiction-statistics/

  2. Entertainment Software Association of Canada. Essential facts about the Canadian video game industry 2018 [Internet]. Toronto (ON): NPD Group; 2018 [cited 2020 Aug 16]. 17 p. Available from: http://theesa.ca/wp-content/uploads/2018/10/ESAC18_BookletEN.pdf

  3. Entertainment Software Association of Canada. The Canadian video game industry 2019 [Internet]. Toronto (ON): Nordicity; 2019 [cited 2020 Aug 16]. 43 p. Available from: http://theesa.ca/wp-content/uploads/2019/11/CanadianVideoGameSector2019_EN.pdf

  4. Lal K [Internet] Healthy Gamer; 2020. Stages of videogame addiction: how bad can it get?; 2020 Jul 30 [cited 2020 Aug 16]. Available: https://www.healthygamer.gg/stages-of-video-game-addiction/

  5. Zialcita P [Internet]. Washington (DC): NPR; China introduces restrictions on video games for minors; 2019 Nov 6 [cited 2020 Aug 17]. Available: https://www.npr.org/2019/11/06/776840260/china-introduces-restrictions-on-video-games-for-minors

  6. Who.int [Internet]. Geneva (CH): World Health Organization; 2020. Gaming disorder; 2018 Sep 14 [2020 Aug 17]. Available: https://www.who.int/westernpacific/news/q-a-detail/gaming-disorder

  7. Ratini M [Internet]. New York (NY): WebMD; 2020. Video game addiction; 2019 Mar 19 [cited 2020 Aug 17]. Available: https://www.webmd.com/mental-health/addiction/video-game-addiction#1

  8. Sullivan M [Internet]. Washington (DC): NPR; Hooked on the Internet, South Korean teens go into digital detox; 2019 Aug 13 [cited 2020 Aug 17]. Available: https://www.npr.org/2019/08/13/748299817/hooked-on-the-internet-south-korean-teens-go-into-digital-detox

  9. Kim V [Internet]. Los Angeles (CA): Los Angeles Times; 2020. He played for 72 hours straight: Korea wrestles with video game addiction; 2019 Oct 17 [cited 2020 Aug 17]. Available: https://www.latimes.com/world-nation/story/2019-10-17/south-korea-video-game-addiction-mental-health#:~:text=South%20Korea%20has%20long%20been,about%20addiction%20to%20video%20games.&text=In%202011%2C%20the%20country%20passed,15%20or%20younger%20after%20midnight.

  10. Zastrow M. News feature: is video game addiction really an addiction?. PNAS [Internet]. 2017 Apr 25 [cited 2020 Aug 17];114(17):4268-4272. Available from: doi:10.1073/pnas.1705077114

  11. Tam R [Internet]. Arlington (VA): NewsHour Productions; 2020. Treating China’s Internet addicts; 2014 Jan 20 [cited 2020 Aug 18]. Available: https://www.pbs.org/newshour/world/treating-chinas-internet-addicts

  12. Kanojia A [Internet]. Healthy Gamer; 2020. China bans video games – an addiction psychiatrist’s perspective; 2019 Nov 7 [cited 2020 Aug 16]. Available: https://www.healthygamer.gg/china-bans-video-games/

  13. Király O, Griffiths MD, King DL, Lee HK, Lee SY, Bányai F, et al. Policy responses to problematic video game use: a systematic review of current measures and future possibilities. Journal of Behavioural Addictions [Internet]. 2018 Sep [cited 2020 Aug 18];7(3):503–517. Available from: doi:10.1556/2006.6.2017.050

  14. Newman A [Internet]. New York (NY): Patch Media; 2020. Asia’s largest gaming cafe open chain opens Malden location; 2019 Oct 18 [cited 2020 Aug 19]. Available: https://patch.com/massachusetts/malden/asias-largest-gaming-cafe-chain-opens-malden-location

  15. Hall S [Internet]. Colgony (CH): World Economic Forum: 2020. How COVID-19 is taking gaming and esports to the next level; 2020 May 15 [cited 2020 Aug 19]. Available: https://www.weforum.org/agenda/2020/05/covid-19-taking-gaming-and-esports-next-level/

  16. Hku.hk [Internet]. Pok Fu Lam (HK). 2020. ‘Survey on the Gaming Habits among Hong Kong Upper Primary Students’ major findings and conclusion; 2017 [cited 2020 Aug 18]. Available: https://www.hku.hk/f/upload/16490/170620_attached_e.pdf

  17. Kwong C, Fong B. Promotion of appropriate use of electronic devices among Hong Kong adolescents. Asia-Pacific Journal of Health Management [Internet]. 2019 [cited 2020 Aug 19];14(1):1-6. Available from doi:10.24083/apjhm.v14i1.199

  18. Medicalnewstoday.com [Internet]. Brighton (UK): Medical News Today; 2020. What happens if you drink too much water?; 2020 May 9 [cited 2020 Aug 19]. Available: https://www.medicalnewstoday.com/articles/318619

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